Health care is delivered in many forms, venues and by different providers. Venues range from hospitals and their emergency facilities, outpatient offices, day surgical centers, storefront ‘doc in a box’, community health centers, concierge service including home visits and by self-help. Providers range from physicians and surgeons with different primary or specialized training, nurses inclusive of advanced practice, registered or license practical, physician assistants, physical therapists, speech therapists and occupational therapists. In addition, self-directed Internet/network-based medical assistance and over-the-counter (OTC) treatments are utilized. These various forms of delivery differ significantly in terms of cost of care, intensity of care, and availability of care. For example, a visit to an emergency room can be very expensive as compared to other forms of treatments. Similarly, a visit to a doctor or other provider typically costs more than using OTC treatments. Of course, cost of care is not always the most important factor for selecting a proper treatment. Other important factors that may affect the selection of a treatment include likelihood of success, adverse effects, whether a treatment is immediately available, etc. Overall, health care delivery and treatments should effectively treat the conditions of a patient in a timely manner.
Unless incapacitated, a person can often freely choose the form of treatment for an ailment, injury or medical problem. Yet when a person does not understand their symptoms or condition, he or she runs a higher risk of choosing a wrong treatment, such as a more expensive but unnecessary one, or worse, may fail to appreciate the severity of their condition. For example, a person suffering a stomachache or a pain in the upper abdomen may not appreciate they have indigestion, which will pass in a relatively short time. In such an instance the person could take an over-the-counter treatment or simply rest, but instead sees a doctor or rushes to the emergency room. Or, at the other extreme, the person has a string of stomachaches indicating a more serious condition, but continually dismisses the stomachaches as gas.
Also of concern is the lack of guidance when people self-medicate or self-treat. For example, when a person takes an OTC treatment, he or she may not be aware of contraindicated substances for that treatment that could lead to serious or even deadly interactions. In such an instance, a person experiencing a symptom may need immediate medical attention.
Certain factors reduce the efficiency of the health care system when a person is in need of treatment. One factor is the relevant healthcare knowledge of a person, i.e., whether a person has or lacks sufficient knowledge to determine the proper health care protocol. People often do not recognize what symptoms indicate a need for urgent care, care that can be scheduled, or can be addressed with self-help. Another factor is a person's medical history may not be readily accessible by a healthcare professional, for example at the point of emergency or urgent care. A healthcare provider may eventually obtain a patient's records, but not in time to contribute to diagnosis and treatment in an urgent care situation. In such an instance, when a patient is incapacitated the accuracy of the patient's medical history cannot be confirmed. Without accurate medical history for the patient, a health care provider may fail to make a correct diagnosis or may misdiagnose a particular patient with unusual baseline measurements as having symptoms as normal, when their unique medical history would reveal a problem.
Yet another factor is that the person can be confused about what causes a symptom and exaggerates the need for urgent care. Although people may not intend to conceal or misrepresent information when talking with a caregiver, caregivers often find a substantial amount of inaccuracy and discrepancy in their patients' self-described symptoms.
Various technologies have been implemented to improve the efficiency and accuracy of the health care delivery. For example, electronic health records are used to make a patient's medical history readily available to a caregiver. Remote monitoring systems and devices can monitor a person's vital statistics, such as temperature, blood pressure, and electrocardiograms (EKG) and forward the monitoring results to associated servers in real-time; such devices can be stand alone devices or enabled as applications in other devices, such as smart phones or even smart watches. Internet/network-based clinical decision support systems such as diagnozit.com, niaclin.com, medgle.com, and simulconsult.com have been developed to help patients or health care providers with diagnoses and treatments. For example, the systems can remind clinicians and providers what to look for during patient encounters, make sure not to duplicate diagnostic testing or treatments, detect and avoid contraindicated treatments, and instruct patients how to self-treat.